This form is intended for Winona County Residents who are over the age of 65. Please do not fill out this form if you are not over the age of 65.
Winona County Public Health is collecting the contact information for those who are interested in being vaccinated with the COVID-19 Vaccine.
Filling out this form helps us know who to contact once we are ready to administer the vaccination. We will contact you to inform you about vaccine availability, as soon as we are able to schedule it. The vaccine is NOT first come first serve.
*If you are currently working with your Health Care Provider to receive the vaccine, please continue to do so. Filling out this form is an indication that you are interested in receiving a vaccine. It does not mean you have registered for an appointment.
The type of vaccine available from the Winona County Public Health Department is the Moderna. This vaccine has been rigorously tested and is safe and effective. This vaccine is given in a 2 dose series, 28 days apart. Individuals must commit to receiving the 2nd dose in order to receive the 1st dose. Before an individual receives the COVID-19 vaccine, a medical provider will share information about the vaccine and instructions for what do to after they receive the vaccine.
Note: If an individual has questions about whether they should receive the COVID-19 vaccine, consult with their healthcare provider.
If you have any questions about this form, please contact us at the Winona County Public Health Department by emailing firstname.lastname@example.org.